Motion made, and Question proposed,
That a sum, not exceeding £568,275, be granted to His Majesty, to complete the sum necessary to defray the Charge which will come in course of payment during the year ending on the 31st day of March, 1916, for the Salaries and Expenses of the National Health Insurance Joint Committee, including Sundry Grants in Aid."—[NOTE.—£50,000 has been voted on account.]
§ The COMPTROLLER of the HOUSEHOLD (Mr. Charles Roberts)
I have been for less than two months responsible for 667 the administration of the National Insurance Act in this House, and there are many details in connection with insurance work with which I have not yet had time to become personally acquainted. I am glad to have the opportunity to-day of hearing the points to which hon. Members attach importance, but I cannot, in the circumstances, go further than promise to give them my careful attention, for I am not, as will be understood, in a position to give an immediate reply to suggestions that may be made in the course of discussion. Of course, at the present time, most of the old controversies in connection with the National Insurance Act are in abeyance and I have no desire to review them at the present moment. They may be revived again later on. I shall confine myself in the present statement I have to make to two main questions.
I want to say something upon the effect of the War on the Department and its work, and to, sketch in outline some assistance which, in various ways, the Insurance Commission has been able to render. Then—and this perhaps is a controversial subject—I shall say a few words on the possibility of economies in administration of the National Insurance Act. Consistently with the maintenance of efficient administration, we have done all in our power to release men on the staff who wished to volunteer for military service. Clerks of military age to, I believe, the number of 533 have been released for military service. Six of them, I regret to say, have already fallen. Other members of the staff have been sent to help other Departments. Those other Departments have in many cases drawn picked able men from the Insurance Commission; and in Departments that have been feeling the strain and in various committees which have been dealing with war work the members of the staff have been rendering efficient and valuable help. It has been suggested by some of our critics that we should gain some economy by that, but obviously as we are paying their salaries there is no particular gain in economy, though I think we have done what might fairly be expected of us in allowing those members of the staff to volunteer. I cannot disguise the fact that there must be some lowering of the standard of administration. You have to work sometimes overtime, but the extra burden on the Department has been borne with cheerful alacrity by those of the staff who remain, and there must be some scaling down in 668 promptitude, and possibly we cannot guarantee equal freedom from error and mistake. That is inevitable in the circumstances, but I hope the Committee will realise that we have done the best that is possible consistently with the maintenance of due efficiency. On other points I need not assure the Committee that the occurrence of the War has raised a number of new problems with which we have to grapple. Three emergency measures have been passed through Parliament, and perhaps the most important of those in its effect on the approved societies is the grant of five shillings relief from sickness and disablement benefit to those soldiers who have come back totally disabled and have secured disablement pensions from the pension fund. That is in accordance with the recommendation of the Select Committee on Pensions and Grants. In some other ways assistance has been given to the approved societies, and I think we have gone as far as we can at present to safeguard the funds of the approved societies from the drain which the War is causing upon their resources. The ultimate effect of the War upon the finances and position of the approved societies will have to be considered when we have more information at our disposal. There may be considerations which will have to be weighed on both sides, but I think we must wait for further information on that point. We realise that the societies are naturally undergoing like the central administration a considerable strain owing to the depletion of members and by the additional work which the War has thrown upon them. They have to record the number of members who enlist, they have to pay maternity benefit in proper cases in the families of the soldiers who enlist. To meet these additional expenses an allowance has been made which will to some extent relieve the societies.
§ Mr. ROBERTS
A number of duties have been undertaken which are strictly outside the purview of the Insurance Commissioners, but I should like to assure Members of the Committee that where we have gone beyond the bounds of our powers we have acted only at the request of the responsible authorities, and only within the limits within which we have been asked to act. For instance, in collaboration with the War Office we have secured medical attendance for soldiers on furlough, soldiers living at home or in 669 billets, and have made known the arrangements amongst the insurance and panel committees. There are the cases of workmen where the camps were being constructed. The Committee will realise that it was undesirable to have the delays which would be involved in making inquiries as to whether men engaged in this particular work, which was work of pressure, were or were not insured under the Act. Arrangements have been made in which medical attendance has been secured to them, the account afterwards to be settled by the military authorities. I may also mention the generous offer made by the medical profession and the chemists to treat the dependants of soldiers serving with the Forces. We have been able there to help in the dissemination of the information and in the preparation of the scheme, and it is, I think, a very generous act on the part of those two professions which deserves all due recognition. There are cases of soldiers suffering from tuberculosis, and here again we have arranged with the War Office that soldiers when discharged afflicted with this illness should vacate their beds in the military hospitals, and without any interval should undergo treatment in residential institutions so that there should be no gap between their discharge from the military hospital and admission to a sanatorium. The insurance committees have helped with this scheme with great alacrity, and grants of £10 per head have been made out of the Grant sanctioned last year by Parliament. A considerable number of soldiers have already been benefited by that arrangement. Then, again, numbers of the Forces engaged in civil employment with the consent of the War Office, such, for instance, as in the Dock Battalions at Liverpool, or those sent-back from the Army to assist in munition work or in engineering work, have been provided with medical attendance and treatment. They have been all given the advantages of the Insurance Act. We had also the case of the Belgians, which raised some novel points. As the Committee knows, residents abroad are not liable, and it was thought that if the Belgians went back early to Belgium they might not wish to be insured. They were allowed in consequence to claim the exemption which was due to them if they could establish that they were ordinarily dependent on some occupation or work in Belgium. In the case of foreigners the employer pays 670 his contribution though the employé does, not, and the 3d. weekly which the employer pays goes to provide in the case of the Belgians medical and sanatorium-benefits. There was one case of a munitions works, where a large number of Belgians are being employed, and there it was desirable to provide them at once after no waiting period, or a very short waiting period, with medical treatment. In those-cases special arrangements have been-made that after a month they are to be-entitled to medical treatment. Special medical cards are being prepared in those-cases, which can be presented to any doctor on the panel, and they are to be-renewed every three months.
There are two other war points which I wish briefly to mention. One of the first difficulties with which we had to deal on the outbreak of war was the rapid rise in the price of certain drugs which were normally prescribed. In their case the Treasury allows a special Grant therefor, and the prices in respect of these drugs are-being fixed monthly by agreement between; the British Medical Association and the Pharmaceutical Society with the approval of the Insurance Commissioners. There is one further point which will, I think, appeal to the Committee. In this case really substantial assistance has been given. Under the principal Act one penny per annum per insured person is available from the Exchequer to carry on schemes of medical research. The Medical Research Committee was set up with an income of about £56,500 a year. It is-staffed with some very distinguished men of science, and before the War they were engaged in the prosecution of a number of schemes of medical research. When the War broke out the whole staff was handed over to the War Office for service in connection with the War. Their buildings-have been turned into a hospital. The staff are engaged in compiling medical statistics, statistics of casualties, and soon. They are taking preventive steps; against the spread of disease and in reference to improved sanitation. Some details of their work have been embodied in a White Paper which has been presented to the House. I really think that no single penny has been better spent by any one of the 14,000,000 insured persons during the year than this particular penny which has been contributed for the purposes of medical research. The Insurance Commission is very conscious of the strain which the War has thrown upon the approved societies- 671 Owing to the fact that many of the members of their staffs are at the War it is undoubtedly difficult for them to get through their work with the efficiency which they would undoubtedly desire. We have done what we can in the Insurance Commission to lighten their work, but if any hon. Members have any suggestions to make which would assist the societies in their work I shall be very ready to hear and consider them.
I turn next to the second head with which I wish to deal. I am in great sympathy with the critics who at this time preach the need for close economy. All my own instincts personally are in favour of economy. The critics who are pleading this cause single out the work of the Insurance Commission for special attention. I would point out in the first place that, besides that stream of criticism, there is another very different stream with which I have already come in touch. There are a number of classes, official and professional, who urge that the great burden of the War should certainly not be thrown upon them. Approved societies, doctors, employers, and so on, all plead that the burden of the War is a national burden, and that, therefore, it should be thrown on the nation as a whole—that means on the Exchequer. That is a conflicting stream of criticism, and if the doctrine of economy is to be effectively preached, the Committee will have to set their faces against appeals of the kind I have indicated. The Estimates which I have the honour to present show some indication of economy. The Vote of the Joint Committee is reduced by some £600,000. There are minor variations which make the net reduction £495,000. That is in some measure due to War economies—the postponement of various schemes of development which would have been undertaken but for the War. For instance, there was a Grant for the institution of Medical Referees, and for extra provision for nursing. These schemes have had to be held up pending the return of peace. The soldiers have the first claim -on the medical and nursing professions, and the civil population must wait. While I sympathise with 'the aims and objects of the advocates of economy, I do not think that they benefit their cause by wild exaggeration and recklessness of statement. In a recent Debate, in another place, Lord Midleton, in a most admirable effort to revive the obsolete virtue of economy, singled out the Insurance Act 672 for public condemnation. If I may read a passage in which he led us to expect that there were possibilities of making economies to the tune of some millions a year—
I must remind the hon. Member of the valuable rule against quoting in this House speeches made in the other House.
§ Mr. ROBERTS
I apologise if I have gone beyond the line. Of course, I will carefully obey your ruling. It is not only in the other place, but in the Press, that criticisms have been made on the work in connection with the Insurance Act, and suggestions have been made for further economies which will serve as my text for explaining what I think is the real state of the case.
§ Mr. ROBERTS
I shall be delighted to hear the observations of the hon. Baronet. The position taken up by the critics is put in a statement which I found running through a section of the Press last week. It was said that the actual benefits provided by the Government amount to only 60 per cent, of the expenditure. That rests on the fact that out of a total expenditure of £25,000,000 under the Insurance Act benefits are put by the critics at the sum of £15,000,000. As a matter of fact they are rather higher. The value of the actual benefits—sickness, medical, sanatorium, and maternity benefits—are about £17,000,000 a year in a normal year. The suggestion made, I think, is that if the benefits only amount to 60 per cent, of the expenditure, the cost of administration is 40 per cent. That moans—some of our critics put it definitely into words—that we are spending about £3 in the cost of administration for every £5 given in benefits. The critics make two mistakes. In the first place they have underrated the value of the benefits, which amount to £17,000,000. In the expenditure there is put to reserve—and it accumulates as reserve—against claims for sickness in the future a sum which amounts to just under £5,000,000. That is, of course, entirely proper action on the part of any insurance fund.
Experts who have criticised the administration of the Act have somehow left that fact out of account. If the Committee would like to know how the income 673 of £25,000,000 is really accounted for, the percentages work out in this way: To reserve, 19 per cent, of the total sum; benefits' account, 67.3 per cent; working expenses, 13.7 per cent. That is to say, if the insurance fund was a private concern—I believe this is the language of the insurance world—the ratio of working expenses to the premium income is 13.7 per cent.—the whole of the income from the State, received from the employers' contributions and from the contributions of the assured representing the premium income of the insurance company. I admit that the analogy is not on all-fours, but I think hon. Members who are experts in the work know quite well that that ratio of expenditure would not be a bad one, and would not compare unfavourably, while it is in many cases very much exceeded. Hon. Members may say that this percentage of 13.7 of working expenses seems a heavy figure, but that is the maximum total of working expenses under the Act. In fixing the figure at that I have put the case against the Act at its highest. I have included sums which are represented in the Insurance Votes which we are discussing now, and also sums taken out for Post Office, Stationery, Customs and Excise, and other Votes. I am also including the expenses of insurance committees and of approved societies. When I was put on the track of our critics in the effort to find £4,000,000 or £5,000,000 which could be saved by cutting down the expenses of the Insurance Act, I made a preliminary exploration to see what was possible in that direction.
I would remind the Committee that, so far as the expenses of approved societies go, any saving which they may make goes to increase the benefits which are at their disposal, and cannot be given over to the Exchequer. I have put their expenses at the maximum. It is calculated at so much per head of insured persons who are members of those societies. Any saving which they can make there will go to reduce my figure of 13.7 per cent, working expenses, and correspondingly to increase the percentage of the total which goes for benefits. That is, therefore, not the actual working expense of the Act. It is the maximum expenditure. Some societies are able to make savings, but how great are those savings I could not know without detailed examination of the accounts of each approved society. This percentage of 13.7 represents a sum of about £3,500,000. Some may say that in that £3,500,000 there are great opportunities for economists.
674 But out of it 75 per cent., or two and a half million, represents the expenditure of insurance committees and of approved societies, so that in that sum there is no saving for the Exchequer, though there may be to the committees and societies. There is the greatest personal inducement to members of approved societies to save on their working expenses in order to get higher benefits. My chances of economy seem to be fading away somewhat. Of the remaining sum £105,000 goes for audit—a work which is indispensable, which cannot, I think, be cut down, and which in any case is not under the control of the Insurance Commissioners.
I am left to find a field of possible economy in two sums of £483,612, which is represented in the present Insurance Votes, and the sum of £287,000 which is expenditure in the Stationery, Post Office, Office of Works Votes, and so on. Under the circumstances any idea that the country can save one million and a half in the Income Tax, or that you are going to get a penny or twopence off tea, by economy in the administration of the Insurance Act is fanciful, and will not bear examination. In fact we are reduced to the domain of minor economies. I agree economies ought to be made, but I note that the critics have it strongly on their notes that the Insurance Commission is infected with the microbe of extravagance, and that the Commission pays no attention to the possible waste of public money. The evidence for that, and the only evidence quoted, refers to affairs three years ago. These are only relevant to-day as illustrative of the mind and temper of the Commissioners. It is said in the Press that in the first three months of the Act the Commissioners ordered 2,800 tons of paper and distributed 175,000,000 leaflets. I have examined that incident, and I find it included 120,000,000 insurance books and cards; and I imagine there is considerable weight in that figure. Those books and cards were required by Parliament, and I think the critics who quote that figure out of a Blue Book should also have noticed that the Blue Book itself, in dwelling on that question, mentioned that the Stationery Office claim that, by careful attention to a particular brand of paper, it had been enabled to save the country a sum of £70,000 a year. On the whole I could not find any evidence of recklessness there. As to the 175,000,000 leaflets, there 675 is a fancy picture of these leaflets being laid on the Table of the House—a picture which does not betray much acquaintance with our ordinary procedure—and of these leaflets being amended and then flung aside in batches of a million. Well, there is nothing of that which is really true. It is true that the leaflets were ordered, and, if the House of Commons will remember what it did last week when it ordered forms of inquiry and certificates of registration by the million, I think I may conclude from that that where the House of Commons realises there is a really important object to be gained, it does not object to a large stationery bill. I think, on the whole, it was an aim of importance that the Insurance Act should be rapidly, promptly, and thoroughly understood. I do not want to detain the Committee on these small minor points, but the country wishes, and the House of Commons wishes, that minor economy should be made.
I have one crumb of consolation to offer to the critics. When the office of one of the Commissioners recently fell vacant—the post of Legal Adviser to the Joint Committee, with a salary of £1,500 a year—the Treasury, with the full concurrence of my predecessor, decided that it need not be filled up. The gentleman in question had done admirable work for the Insurance Act, but the period of stress and strain was over, and I think that, on the whole, his place can be supplied in other ways. If anyone is really anxious to further the minor economies, he can perhaps assist by giving three or four days' notice of questions. That is not a matter which is of as much importance to-day, when the interests of the House of Commons has died down in matters of insurance; but when there were thirty, forty, or fifty questions a day from hon. Members interested in the working of the Insurance Acts, these questions had, in many cases, to be telegraphed to Dublin, to Edinburgh, and to Cardiff, owing to the national organisation of the Insurance Commissions, and I quite admit that there was there an expenditure which, though not large in bulk, could well have been dispensed with. The Committee knows that the organisation of the Insurance Commissions has often been criticised as expensive. We cannot discuss any amendment of that now, or I should be once more called to order by the Chairman; but I think the time is come to see whether there is any expenditure which results from that system of organisation which admits of 676 being cut down. I, for my part, should heartily welcome the new inquiry by the Treasury into the working of the Departments which was indicated in another place. The matter is being considered in the Department. Abstract economies may be praised occasionally, but concrete economies are generally very unpopular and disagreeable. Still, I think the House and the country expect that resolution and increased care will be shown in the future.
I have only one word further in this connection. You cannot cut down the efficiency of the administration beyond a certain point. During war time you have to expect makeshifts, postponements, and we can make allowances, but any real inefficiency in the administration of the Act might work out into poor persons losing the help and the comfort which are their due under the Act at a time of stress and trouble. You cannot so economise as to run the risk of a maternity benefit, for instance, being paid some four or six weeks after the proper time, or an assured person failing to get his proper sanatorium treatment in a sufficiently early stage of his disease. I believe the Act is performing a work of vast beneficence in the country at the present time. It will not be less indispensable after the War, in the days that are to come, and for the sake of men who may come back from the War in bad health and on all other grounds the efficiency of the administration must be maintained.
§ Sir F. BANBURY
The hon. Gentleman, when he commenced his remarks about economy, said that the critics had singled out the Insurance Commission for their comments on economy. That does not apply to me, because I think in nearly every Department of the Government economy could certainly be made, and it is not necessary to single out any one Department. I have already, within the last ten days, singled out the Land Valuation Department, which, if anything, is worse than the Insurance Commission. The hon. Gentleman stated that certain economies, if they were made, would affect the insurance companies, and that they would not affect the Exchequer: That may be quite true, but economy is a good thing whether it affects the Exchequer or anybody else, and if economies in the administration of the different companies that look after the insurance can, be made they ought to be made. However, I propose this afternoon to deal only 677 with that amount of money which is spent by the State. If there were not what is called a political truce, I think I could make a very good case against the late Government. I observe that the hon. Gentleman did not say anything about the total cost, which, as far as I can make out, is over £9,000,000. It is not very clear, because you have to look about amongst the pages to find out certain items which are included in other Votes.
§ Sir F. BANBURY
If the hon. Gentleman will look at the Estimates I think he will see that I am correct. He will see that the total is £21,787,060, all of which, except £13,089,000 for old age pensions, belongs to insurance. If you deduct £13,089,000 from £21,787,000 you arrive at £8,700,000. If you look a little further on you will find there are on the other Votes £5,000 and £283,000.
§ Sir F. BANBURY
Labour Exchanges and unemployment insurance are so mixed up that it is difficult to tell how much belongs to the unemployment insurance and how much belongs to the Labour Exchanges.
§ Sir F. BANBURY
But the unemployment insurance is certainly part of the National Insurance and "was in the same Bill; therefore it ought to be included in the expenditure.
§ Sir F. BANBURY
It may have nothing to do with the hon. Gentleman's Department, but the taxpayer has got to find the money, and that is the point which I want to emphasise and which a great number of people are thinking of at the present moment. Then the hon. Gentleman dealt with leaflets. It is necessary to send out I 678 forget how many millions of leaflets in order that people may understand the Insurance Act. It possibly was in the interest of a certain political party, and I think the hon. Gentleman used those words himself.
§ Sir F. BANBURY
I think he did; at any rate, it was in nobody else's interest. The only reason was because it was in the interest of a political party. [HON. MEMBERS: "No!"] That is a matter of opinion. In my opinion, it was. I would point out that the hon. Gentleman first of all said there was a saving this year, and so there is. It is a very small saving, but it is not a saving on the original Estimate of last year. On page 2 the total expenditure is given as £21,787,000, and there is a little footnote which says that the total original net Estimate for 1914–15 was £21,036,000, so that on the original net Estimate there is an increase. That £21,036,000 was increased by Supplementary Votes, and of course we do not know whether we may not have Supplementary Votes later on this year. Taking the original Estimate, there is, as a matter of fact, an increase upon the Vote of last year. I may, just for one moment, deal with the expenditure which comes under the heading of these Votes—the expenditure which the taxpayer has to pay. I will not say my figures are correct to a pound or two, but they are correct to within £500 or £1,000. Now I find, out of an expenditure of, roughly speaking, £9,000,000—I am not including in this the Labour Exchanges, on which there is for salaries, wages and allowances, £569,000—it appears that £454,000 is spent on wages and salaries; nothing for paper, nothing for office expenses—merely wages and salaries, £454,000. Then there are travelling expenses, £40,000; they must travel a great deal to spend £40,000.
§ Sir F. BANBURY
In addition to that there is £838,000, which is granted to the insurance societies for expenses, so that altogether there is £1,400,000 actually spent in wages, travelling expenses and Grants in aid of the expenses of administration (societies and committees). That is an enormous amount. It is something like 15 per cent, on the amount contributed by the State, and that does not include office expenses, rent, paper, stationery, or any of the other various items 679 which have to be provided. It seems to me that there is great room for economy in this direction. I cannot conceive why we want to spend £1,300,000 in salaries, wages and expenses of administration of the societies. I presume the societies spend a considerable sum themselves in expenses of administration, and therefore I am not at all surprised that it has been stated that the benefits are, comparatively speaking, small. The hon. Member for Lincoln admits that the cost is £3,500,000. It seems to me that it is difficult to show that anyone is receiving any benefit at all under the Act. [HON. MEMBERS: "Yes they are!"] I will not go into that because it may be regarded as controversial, but my experience is that we should be a great deal better off without the Act than with it.
§ Sir F. BANBURY
Workmen and employers. I should be very much obliged if the hon. Gentleman opposite can explain why it is necessary to spend these enormous sums in salaries and wages. I do not want to make any charge against the present Government or the last Government, but I do hope that the hon. Gentleman representing the Commissioners, who seems desirous of instituting economies, will cast his mind over these matters and see whether he cannot get the work equally well done by a considerably smaller number of people at a considerably less salary. The hon. Gentleman said economies are always unpopular. Of course they are. Naturally the person doing half a day's work and receiving more pay than he ought to does not like to be told to do a whole day's work and have his pay cut down. The hon. Member is there not to make himself popular but to look after the interests of the taxpayer and see that for every sovereign he spends he gets a sovereign's worth. All Governments of late years have failed in that respect, because their desire has been not to do anything which is unpopular. Their desire should be to do the right thing, without caring whether it is popular or unpopular. I do not suppose that I am doing a popular thing in saying that there is a great deal of money being wasted in salaries, but I believe it is so, and I believe the work could be done well with a far smaller staff and smaller salaries. It is because I believe that is so that I feel it is my duty 680 to get up and make the few remarks that I have made. I do not know whether it will be possible for the hon. Member for Lincoln to tell us how far he thinks this expenditure is likely to rise, and whether there is any chance of its diminution. When the Insurance Act first became law no one ever contemplated that there would be anything like £9,000,000 spent upon it. I have got out the figures, but I will not give them for fear that I should be tempted to make a more or less controversial speech, but I should like some assurance from the hon. Gentleman that he really does appreciate the great importance of effecting economies in every direction. As he is a new broom, and there is an old proverb that "new brooms sweep clean, "I hope he will give me some satisfaction before the Debate closes today. We are in a peculiar difficulty because, under present circumstances, I could not very well divide the House upon this question, but in ordinary times I should have done so in regard to this great waste of public money. The Prime Minister himself at the Guildhall the other day, as well as my right hon. Friend the Secretary of State for the Colonies, advocated economy with great force and power. I do not see either of those right hon. Gentlemen present, and I do not see many hon. Members on my old side of the House, but if we are going to have a campaign in favour of economy it will be necessary for hon. Members to take a little more trouble and interest themselves on this subject, or we shall gain nothing. With the exception of two hon. Members on the opposite side, all the others are for extravagant expenditure without regard to where the money is going to come from. I really trust that the House will consider these questions very carefully. It would be out of order for me to enter into a Budget discussion, but I really do not know where the money is going to come from, and I am quite sure, when the War is over, the position of the country will be extremely serious if we go on spending these enormous sums of money.
§ Mr. BOOTH
I am sure that is so, and if the hon. Baronet will only read this homily to every Government Department I will promise to be present to support him. I would, however, remind the hon. Baronet that this is scarcely the time for paying off old grudges which are a few years old, and which arise from a difference of conception by hon. Members of this House in regard to the insurance scheme. I think it would be much better to turn our attention to the effect that the War has upon the finances of the insurance scheme. I would remind the hon. Baronet before I leave him that if he had taken the trouble to turn up the Debates on the Insurance Act he would have seen that I did announce to the House that the sums of money the Government were then voting would be nothing like sufficient, and would have to be increased. I know at the time some people were very sceptical about the matter, and I was like one crying in the wilderness. Now we are face to face with the position that the Commissioners can control this matter very little. The machinery was set up by this House, and so far as economy is concerned they can effect some economy in their own administration, but they cannot effect the saving of millions of pounds, which apparently some hon. Members opposite think ought to be done, without repealing the Act. Therefore any talk of this kind, whether in another place, in the Press, or in this House about saving millions cannot possibly apply to the insurance scheme. I welcome the hon. Member for Lincoln upon his first appearance in his present position. I think he is the sixth Minister who has answered insurance questions in this House. I would like to point out an omission from his statement. The hon. Member made no reference to the number of people under insurance or of the effect the War has had upon those figures. He also made no reference to the finance, and he did not say whether the actuarial calculations for men and women had been found to be sufficient. He did not say what financial burdens the War had already thrown upon the scheme in regard to the return of soldiers in imperfect health.
I should have thought that this was a very good opportunity for having a searching inquiry into the working of the Act, seeing that we now have a united Government, because it could not be taken as a party move. I should include in the inquiry the conduct of the Commissioners themselves, both as regards the Joint Committee and the National Commis- 682 sioners. I do not mention those bodies because I have not a great respect for them, but seeing that there is a considerable amount of uneasiness in the country and in this House about this scheme, and seeing that it is now nearly four years since it was passed, I should have thought that it was necessary to institute an inquiry in order to inform and assure the country generally how the Act was working. An hon. Member has already hinted at a Treasury inquiry into some small point. I do not know who first suggested that course, but I believe the suggestion was made in another place. In my opinion that would not meet the case at all, and I hope hon. Members in every part of the House will have an inquiry which has the seal of this House set upon it, rather than one Department of the Government inquiring into another Department which is directly under its control. I rather think the hon. Member for Lincoln himself is a Treasury official, or perhaps he is a Household appointment. Anyhow, if he is a Household appointment he is the first that has taken charge of this matter, because all the previous spokesmen have been Treasury officials. We have had the Chancellor of the Exchequer, we have had the Financial Secretaries to the Treasury, and we have also had an exception in Mr. Masterman, who after his appointment as Chancellor of the Duchy of Lancaster was allowed to keep the post ho had occupied in regard to the National Insurance Act, which was given to him because he was Financial Secretary to the Treasury, and he was thought to be so indispensable that the work of the National Insurance Commissioners had to follow him when he was appointed to that joyful sinecure the Chancellor of the Duchy of Lancaster, a Department which looks after the cricket grounds at Pontefract and neglects them.
The Insurance Department was set up, and it was complained that the Treasury, instead of being the custodian of the public purse, was turning itself into a great spending department. Therefore to have a Treasury inquiry into a matter of this kind would be like appointing the head partner in a firm to inquire into the conduct of his junior partner. While I do not object to the Treasury inquiring into the conduct of their own offspring, what I think is required by the community is an examination from the general or public standpoint to see whether the Act is answering the wishes of those of us who helped to pass it into law. I do not think we ought in our 683 approved societies to have our attention diverted any more than can be helped by new regulations relating to the conduct of the War. Those working the Insurance Act have their minds principally centred upon the War, and the Commissioners appear to be choosing this time, when they think the House is quiet, and free from criticism, to issue these regulations. There is a temptation to them to take this opportunity to issue circulars and regulations, and to attempt to make a change in the administration. I am not uttering this warning without some foundation. What has happened of late to the Advisory Committee? The Commissioners are contemplating, as far as I can make out, important changes in the administration, but they do not call the Advisory Committee together. At a time when, in politics, we are uniting, and when Ave see the advantage of combined counsel and cooperation, the Commissioners do not see it, and are not consulting this advisory body.
I have had reported to me—it comes from so many quarters that I cannot disregard it—that there is a lack of sympathy, on the part principally of the English Commission. There has been controversy in this House with regard to the position of this Joint Committee, and the establishment of separate national Commissions. Approved societies express their satisfaction and their appreciation of the work of the National Commissions in Scotland, in Ireland, and in Wales, but that satisfaction does not obtain in this country. There may probably be a little misunderstanding, because I cannot think that there is any less real or actual sympathy on the part of the English Commission. Still that position does obtain, and I invite the hon. Gentleman to use a little of this large sum for travelling expenses and to go about the United Kingdom himself. It has been my duty occasionally to preside at conferences of insurance workers from all parts of the United Kingdom, and repeated complaints come from trade unions and from friendly orders, as well as from other large societies, or, at any rate, from the provincial men. I have generally pulled the speaker up, and he has always said that he means the English Commission. Immediately Irishmen, Scotsmen, and Welshmen have got up and have repudiated such a state of things as applying to their own country. That 684 has been the case at more than one conference at which I have presided.
It was intended originally that the societies, the insured persons, should have a large influence upon the opinions and the work of the Commission. It is not easy for men who are academical, and who know of these things from theory, however clever they may be, to understand the enormous difficulty of working it out in detail throughout the country. Regulations have been issued which have puzzled Members of this House. I will undertake to say, if Members of this House attempted to understand the regulations with regard to arrears, that there would not be 5 per cent, who could give an intelligible explanation of them. The approved societies, who can command very capable men, have put the ablest brains on them to decide what they mean, but very often the local secretary is a man who works at his trade during the day, who comes home and clears a place on the tea-table, and, with children running about and shouting and crying around him, he gets his papers and tries to do his duty to his fellows. You cannot in the villages and small towns pay for university men, and men with degrees. Unless these working men do the work, the Act will not be locally administered at all. They attempt to unravel all these circulars and leaflets which the Commissioners shower upon them, and they are bound to give it up. When they come to me, I say that I left off trying to keep up with the stream of leaflets coming from the Commissioners years ago, because one found that the information which came from live men who were able to give you facts was apt to be misplaced by attempting to analyse great multitudes of leaflets. It may have been inevitable, but that is the position.
It surely was the intention—it was so stated in this House—that the representatives of approved societies should have a large place in administering the Act. Yet there is not one of them on the Joint Committee. When that promise was given in this House, the intention was to have one Commission. There was no suggestion of National Commissions. There was to be one supreme Commission, and upon that Commission the Industrial Insurance Societies were given to understand that someone who had great know-ledge of their work, someone from the friendly societies and someone from the trade unions would be placed upon it. Then the idea of National Commissions was brought forward, and a Joint Committee, a super- 685 edifice, was placed over them, and upon that Joint Committee their representatives were not given a seat. We accepted the inevitable at that time. There was an intense desire on the part of all those large approved societies to work the Bill in harmony with the administrators, and little was heard of it, but gradually disappointment has come upon us. We naturally thought that with regard to the National Commission for England, that being by far the largest, the position of those who have spent their lives in actual touch with the democracy in its thrift expression, would be considered, but gradually the work seems to have been removed, so far as I can make out, on to the Joint Committee. I do not challenge the Joint Committee; it is a desirable institution, and I am perfectly certain that the administration in London gains largely by the chairman of Scotland, the chairman of Ireland, and the chairman of Wales coming up to the Joint Committee.
I hope that I shall never say a word that will have the inference that the Committee should not get the value of the services of those men. They have done a great deal to smoothe out the working of the Act, and to place valuable experience at the service of London and Whitehall, but now we hear that one of the most active men upon that Commission, one of the two or three prominent spirits, is leaving it, and that he is not to be replaced. I am not sure that is really good economy. I should have thought that this was an excellent chance for strengthening the Commission on its representative side. Now that the Act has been before us for about four years one would have thought that they would have been able to point to men of public spirit, of great capacity and of great devotion to the Act, who could with advantage have been brought into their counsels. Instead of that the Advisory Committee is not meeting and it is not proposed to fill up this place. It gives great concern indeed to those men who are working the approved societies outside, as to whether they will have the consideration to which they are entitled.
The basis of this Act "is that of service through the voluntary societies. If that is lost sight of the Act must crumble. It was that which recommended it to the people, and it is that which has made it efficient. The great bulk of the 13,000,000 are in societies. There is only a very small number at the Post Office, and, if the right 686 of self-government of these approved societies is recognised, they will do a great deal. There is a great deal of voluntary service being put in, and even those who are paid are not adequately paid. Under these circumstances, I do not think that I am making an unfair claim when I say that these men and women, giving their valuable time to work in these organisations without reward, are entitled to the fullest recognition from the Commission and from well-paid Civil servants sitting at Buckingham Gate. I make these remarks entirely on my own, not having been asked by anyone to put them forward. I have carefully avoided identifying myself with the work of any particular society. I have been invited over and over again to take posts, and up to the present I have always felt it my duty to refuse. Therefore I speak in this House entirely unbiassed, but I think that I am in as close touch as any Member with all the various members of approved societies. I offer these criticisms in good faith.
I also wish to ask about the valuation. No reference was made by the hon. Member as to whether the valuation would be made at the right time or would be postponed. I take it that it is anticipated that the valuation will not take place at the expected time, and that it will be postponed. That has its advantages and its disadvantages. For those societies which are on wrong lines, or which are working on a wrong basis, it will increase the danger, but for those societies which have not perhaps quite adapted themselves in the most perfect way it may be a convenience. I do not know what reasons the Commissioners have had for coming to their decision. I do not know on what information the hon. Member founded his remarks about the benefits which are being paid. The Commissioners naturally get later information than the 'approved societies; but I would like to say, as far as I can observe, that the calculations for the men are good. I know in previous years in this House and in the Press fears have been expressed that the actuarial basis of the Act was unsound, but I do not think there is any doubt now that, so far as the men are concerned, the actuarial basis was sound, and that the benefits are quite in accordance with the contributions. There seemed to be an epidemic of sickness in the first year of the Act, and in addition there were, no doubt, many persons who were waiting for the Act to bring forward their claims. Now that those have been 687 dealt with and sickness has resumed its normal condition, it is seen that the main structure of the Act, at any rate so far as it applies to men, is sound and wholesome, and I take this opportunity to congratulate the actuaries on the estimates they framed. There is no doubt that they were largely taken from the experience of the Manchester Unity of Oddfellows, but still their figures were small compared with these, and it shows that they were careful and able men.
With regard to the position of women, surely the Commission by this time realises that the figures are not sound. You cannot possibly pay more benefit than 6s. instead of the 7s. 6d. per week upon the present rate of contribution. I know that some special societies, such as domestic servants, may produce very good results, while others, such as laundresses, are producing very bad results; but one can only take the general figures spread over the insured female population, and even in the well-managed societies of each grade—the well-managed society of the industrial class, the -well-managed society of the friendly orders, and the well-managed society of the trade unions—in nearly all those it is clear that the benefit paid to women—7s. 6d. per week—is too much as compared with the contributions from all sources. This is a matter which the Commission will have to consider, and if, by postponing that consideration, they are able to arrive at some happy solution, the time may not be ill-spent. But I think the Committee is entitled to know what are the views of the Commission upon that point. The War is bringing into the ranks of weekly wage-earners large numbers of young women who were not under the Act before, and I should have thought that the lion. Member for Lincoln would have seen his way to discuss this question. Perhaps I am unreasonable in view of the fact that he has only just taken up this post, but undoubtedly the Committee would have preferred to have had this large and important question discussed.
Another important point in regard to finance is the cost of the county committees and of the insurance committees generally. I am not at all sure that they are worth the expenditure incurred. I do not know what the Commission think about it. The committees were no doubt set up from very good motives, and to some extent they may be considered necessary, but there is a very great deal of time wasted on them and a considerable amount 688 of money as well, which may lead eventually to a financial breakdown. I understand that in the county of Glamorgan the rate of expenditure under this head has become very alarming, while the position of the London committee in this, respect is almost heart-rending. A special staff committee was appointed to reorganise the office, but could not see its way out of the difficulty. As far as I can gather, it is utterly impossible in London to put the register right and use the card system as devised by the Commissioners on the amount granted for the purpose. I am afraid the remedies which have been suggested will constitute an excuse for putting some of the cost on the approved societies. I should like to know whether that is in the mind of the Commission. If you cannot get this money from the Treasury, and if you do not get a sympathetic answer from the Exchequer, there is only one other source from which it can be obtained, and that is out of the contributions of the working people.
§ Mr. BOOTH
My hon. Friend is no doubt well qualified to speak for that section. I want to utter a warning note. If these committees are to keep on this very cumbrous card system, which is crippling their work and running them short of funds, and if the deficit is not to come from the Exchequer, it can only come from the approved societies, and it may mean a reduction of benefits, because anything you take from approved societies can have only the effect of reducing the benefits. If there is a surplus on the management fund of any society that must go to the benefit of the members, because it is a cardinal principle that good management shall be for the benefit of members who elect their own officials. I want to know where are these committees drifting to? I have not been convinced of the necessity for this intricate card register system, and I should have thought that some simpler form than that could have been arranged. I do not know whether the hon. Member for Lincoln is aware, or if he dare tell the Committee, how many hundreds of thousands of insured person's cards there are that cannot be traced. We have been debating just recently a national register, and the hon. Member for Lincoln to-day tells us that he and his colleagues have been exercising their minds as to the manner in which they could best help the Government in 689 that matter. One would have thought that as they have a register of thirteen million insured weekly wage earners in this country, they would have been the authority which could assist in the matter; but apparently that is not the view of the Government. It prefers to go to the urban district councils which have no registers at all.
Largely owing to the fact that they do not realise the character of the work, the number of cards that go astray, and the vast number of removals that occur, the committees are at present in a very unfortunate position in many parts of the country. I do not know whether hon. Members are aware that if you take up a stray card there is nothing on it to show to what society the insured person belongs, and there is no means of tracing him therefore in that way. The consequence is that in nearly every district throughout the country they are utterly bewildered by the stacks of cards which are unappropriated, and in London the number of these is really overwhelming. I say quite frankly that, in my opinion, this is a problem which cannot be solved, and I defy the Insurance Commissioners to go into our offices in Chancery Lane and provide a solution. In some cases the officials have been blamed for not having accomplished the impossible. Of course officials are not all alike; some are more adaptable for dealing with problems of this kind than others. But in a great place like London it docs seem absolutely hopeless, on the money allowed, for the committee to solve this register problem. I do not know whether it would be worth the trouble if the money were spent, but I do not see why the Commissioners themselves should not take the responsibility, and I am sure my colleagues on the London Insurance Committee, among whom are to be found some of the best organising minds in the whole of London, would be glad if the Commission would undertake to deal with the problem, which to them seems almost insuperable. The Commissioners should take this matter into consideration in this time of war.
I do not wish to press my own personal point. I will take the case of some of my colleagues who are battling with this problem and trying to carry out the recommendations of the Joint Committee over which the hon. Member presides. A good many of them are busy organising munitions work and addressing recruiting 690 meetings, and I do think they are entitled to some consideration, and that their work on the Insurance Commission should be made more simple than it has been in the past. I have no doubt that some of the permanent officials think it is easy to solve the problem; they have very clever brains and are in possession of a great deal of information. Their policy is to send out a circular broadcast, and, when that is done, they exclaim, "Thank God that job is over!" But that is only the beginning for those who have to administer the Act. I know it will be said that all these complaints have been made before, and that ever since the Commission started people have emitted groans on this point. This is. a time not merely for economy in finance, but for economy in system. There should be simpler methods of dealing with this is insurance problem than this cumberous card index. It cannot last. The committees have made a gallant struggle with it, but according to the information which has reached me in many districts the trouble is-growing, and instead of getting up with the work the committees are getting-further behind. I, therefore, feel it my duty to speak out.
It is one advantage of having a united Government that we can say these things in a frank way which will not be resented. On previous occasions when I have made-suggestions with regard to possible improvements in the working of the Act, my personal friends have invariably come to me and complained that I have been giving points to somebody opposite which will enable them to criticise the Government. I trust we can have some information today upon the various points I have-raised, on the effect the hon. Member-thinks the War will have on the financial side of the administration, and which it certainly will have when the cripples are coming home. I do not mean men crippled by the loss of a limb, but men who have had to stand in deep water in the trenches who coma back with rheumatism in their system and who, when they attempt to work at their respective trades, will soon come on the Insurance Fund. They will not be regarded as wounded in the War. I want to know the opinion of the hon. Member with respect to the working of the insurance committees and, further, on the actuarial position regarding women. Has he any suggestion to offer upon any of these points? It is of no use for him to bury his head like an ostrich in the sand. He has before him one of the greatest problems any Minister has ever been 691 called upon to deal with, and I am bringing it forward in order to make quite sure that he knows of it. We shall, I am sure, be quite ready to give him all the help we can in trying to solve it for the benefit of insured persons.
§ Sir J. D. REES
The hon. Member for Lincoln introduced this matter in a very temperate speech in which he moderated the transports which characterised his predecessors' speeches and led him into melancholy exile. But in stating that economy was desirable he very effectually showed that he would be unable really to effect any economy. That is what I understood from his review of the situation. The hon. Member for Pontefract (Mr. Booth), whose speeches are generally exceedingly clear as to their purport, whether we agree with him or not, has to-day delivered a speech which leaves me in considerable doubt as to whether lie is really advocating any concrete economy. I gathered he actually disapproved one concrete economy proposed by the hon. Member for Lincoln—the absorption of one post which might be dispensed with. The hon. Member's speech appeared to be a general condemnation of the administration of an Act of which he is usually a strong supporter. I cannot follow him in the details with which he dealt, because I have not that intimate knowledge which he possesses, but I must confess he was not so clear as he usually is in his speech. I regret he should not have encouraged the hon. Member for Lincoln, who showed considerable courage in proposing to abolish one solitary official. May many more be? dispensed with in order that money may be available for those causes for which it is more required, and not squandered on establishments without which the country at the present moment is able to do. I agree entirely with every word said by the hon. Baronet (Sir F. Banbury). All that I heard I readily adopt, and that which I did not hear J am certain was in the same vein, and equally worthy of adoption. I do not intend now to enter into any criticism of the Act, which I, myself, would gladly see suspended and, if possible, abolished. I want to ask the hon. Member for Lincoln if. when reviewing the administration, he will look into the case of the outworkers. I do not wish to trouble the Committee with that matter now, because I have done so on previous occasions. A commission was appointed by the Glasgow University 692 concerning the effects of the want of proper nourishment on the people of this country. That becomes relevant to this extent, that it was found that the contributions to the Insurance Act, small though they are in actual amount, were considered by this commission to be such as to put a very grievous strain upon the health of the people. I hope the hon. Gentleman will look into that matter. I will provide him with the reference in order to save him the trouble.
The hon. Gentleman referred to the question of medical research. Is it to be understood that out of the funds collected from the taxpayers compulsorily money is paid for medical research in connection with the Insurance Act? If so, it is a gross misapplication of funds compulsorily collected from the taxpayers. If such research work is necessary, surely it was never intended that money which is compulsorily taken from the taxpayers for insurance should be applied for that purpose. It may be a very necessary and extremely proper subject, but this money, at any rate, should not be diverted to that object, and I beg to enter my protest against it on behalf of those who pay, of whom I suppose I am one. With regard to the expenditure upon which the hon. Baronet (Sir F. Banbury) commented, I am one of those who receive all the leaflets that are issued. I put my name down at the beginning, and I have received them. I wish to associate myself with the hon. Member for Pontefract when he says that large numbers of those normally intelligent could not understand these leaflets. There are tons and tons of stuff printed which is perfectly useless for the object for which it was intended. These circulars may have been intelligible to the trained capacities of the Gentlemen who sit underneath the Gallery, who have their intelligence trained day by day, month by month, and year by year, in order to understand that which is practically unintelligible. This stuff is printed in tons and published broadcast. I receive it day after day, because I put my name down in order to find out what was going on, but with no intention of reading it. It is really a gross abuse. Whoever publishes what is not required is a public enemy, and whoever does that at the public expense is still more a public enemy. There is great room for economy in the administration of this Act, and at the present moment of all times economy should be enforced.
693 The hon. Member for Lincoln mentioned in passing the figure of £3,500,000 as the working expenses in connection with these compulsory collections. He said that a good deal of that money went into reserves. I do not think reserves ought to be collected under this Act now. There should be no reserves in anything. All the money that is possible should be devoted to the purposes of the War only. Of course, the hon. Member opposite (Mr. Booth) will not like that. He looks upon it from the point of view of an expert in insurance. I am speaking from the point of view of the taxpayer. I quite understand his objection, and how easy it is for him to demolish what I say from his point of view. I submit that all these principles should disappear at a time like this, and that there should be no building up of reserves, under this Act or any other Act, in respect of money collected from the taxpayers. What is not needed for carrying on the War should be left in the taxpayer's pocket. He will stand in need of it before the War is over. I wish to express my regret that the hon. Member for Pontefract (Mr. Booth), who is an independent Member and is an expert in this matter, should not have encouraged the hon. Member for Lincoln in greatly daring to propose to make one small economy.
§ Mr. C. ROBERTS
I claim no credit for it. It was done by the Treasury with the concurrence of my predecessor.
Mr. TYSON WILSON
On the last occasion I ventured to criticise the administration of the Insurance Act, and, owing to the criticisms, I was asked certain questions. I answered those to the best of my ability, and the reply I received was that the matters were not of very much moment but that they were receiving consideration, and that in the near future further regulations would be issued in connection with the complaints I made. I associate myself with the remarks of the hon. Member for Pontefract (Mr. Booth), as to the enormous amount of literature issued to people who have to administer the Act. I should say that not 15 per cent, of the secretaries who administer the Act ever look at the circulars that are issued, because they feel quite satisfied that in a month or two months' time new leaflets will be issued contradicting those issued previously. I would appeal to the hon. Member for Lincoln to 694 do all he possibly can to stop the issue of so many regulations and, if possible, make the regulations simpler than they are. At present they are not at all simple. I know from my experience in connection with trade unions and friendly societies that it takes a considerable time before one can quite understand what is meant by some circulars, and a considerable amount of time is spent referring to the Sections of the Act with which a leaflet may deal.
Some of the circulars issued by the Commissioners directly contradict the rules of the societies affected. When the Act was passed, those rules were altered with the object of making them comply with the regulation issued by the Commissioners. Now new regulations are issued which make the rules of some of the societies absolutely null and void. I would suggest that before the regulations are issued the societies affected ought to be consulted to ascertain whether the regulations make any great difference so far as their rules are concerned, because in many small towns and villages where there are lodges and branches of societies the secretaries do not know what to do when they have to tell their members who are on sick benefit that they must comply with the rules of the society. Then they find some official calling and saying that the regulations issued by the Commissioners have been violated, and the poor sick member has to comply with the new sets of rules and regulations. That should not be. The regulations should be simplified in order that the men who are doing the main work in connection with the Act can understand them.
I should like to say a word in connection with the Audit Department. I see there is an increase in the expenditure of that Department. I was told that a considerable number of the staff had joined the Army and that they were short of auditors, therefore I should have thought that the expenditure on that particular branch would have been reduced instead of increased. I was also told that the Commissioners or the Treasury had said that the auditors must not be allowed to join the Army, although many of them were quite willing to do so and were eligible so far as age is concerned. I do not think that any Government Department should hamper any of its staff who desire to join the Army, at any rate at the present time, but should rather encourage them to do so. The working of the Act ought to be better understood now both by friendly societies' 695 officers and the trade unions officers, and that being so there ought to be less work for the auditors now than there was at the beginning of the Act, and not so many of them should be required. So far as inspectors are concerned, there is room for a reduction in their number. They were supposed to educate the officials of the societies who were to administer the Act. After two years of experience, those responsible for the Administration of the Act must understand it better than they did when it was first introduced, and there is no occasion for the present large staff of inspectors. I hope the hon. Gentleman will look into those matters. I believe some economy could be effected, starting at the top and coming down the list, perhaps halfway. Certain of the staff are overpaid at the present time, while typists and others are not overpaid. So far as the higher officials are concerned, there is room for economy, and I hope the hon. Gentleman will do something in that direction.
§ Mr. WARDLE
I can understand the position of the hon. Member opposite (Sir J. D. Rees) in wanting to do away with the Act altogether or to suspend it, but if it is to remain in operation I certainly cannot understand his desire to do away with the building up of reserves. So far as concerns those engaged in the administration of the Act, and especially looking at what is likely to happen after the War is over, the building up of reserves, even from the point of view of carrying on the War, is one of the most necessary operations the Commissioners can take in hand. I should like to associate myself with those who have expressed a desire for a cessation of some of the circulars which have been issued, or, what I think would be far better and lead to real economy, namely, the codification of all those that have already been issued. I should prefer both codification and an index. If they were codified the whole administration of the Act would be simplified.
I chiefly rose to deal with one small point with regard to the action of the Commissioners which has lead, I believe, in many places to what are called stock medicines being brought into operation. I understand that doctors have started a system of stock medicines, and that the Commissioners have to some extent authorised this. I am quite sure the hon. Gentleman will see that if there is any indication whatever of the treatment of 696 patients under the Insurance Act being less efficient than that which a private patient is able to receive from a doctor, that will militate strongly against the Act. The idea of having these medicines stocked in large quantities—a very old method which was in operation in the old dispensaries twenty odd years ago—has the effect of deteriorating them, and it also has the effect, I am informed, of making a doctor rather inclined to give a stock medicine than to write out a prescription which will exactly fit the case which he is diagnosing. If that be true, I sincerely hope that the whole question of stock medicines will be gone into thoroughly, and if the objections which I have raised, and which I assure the hon. Gentleman are causing a considerable amount of irritation in certain quarters, are looked into and, if possible, obviated, then there will be a smoother working of the Act than there is at present.
§ Mr. DAVID MASON
My hon. Friend (Mr. C. Roberts) referred to the cost of administration and said it compared very favourably with workmen's insurance generally. I should be sorry if it went out that we were to consider that such a very favourable comparison, because it is hardly a far comparison. Surely the only way in which you can compare the cost of administration would be to compare it with a similar compulsory State form of insurance in other countries. Take, for example, the Post Office employés. Theirs is a free system, so that the ratio which my hon. Friend gave us to believe was a very low one is hardly a fair one to state, and it might convey a misleading impression. I think my hon. Friend showed that he is anxious to initiate some system of economy, and I am sure, from the admirable speeches we have heard, that he will have the support of the House in any form of economy whereby he can cut down the staff without impairing the efficiency of the administration of the Act.
§ Colonel YATE
The hon. Gentleman, T think, said that arrangements had been made that all tuberculous soldiers were to-be transferred from military hospitals to institutions without any break of treatment. Could he tell us if the institutions are all ready to receive the men transferred?
§ Mr. ROBERTS
I have been very much interested in the various criticisms which have been made, and I assure the Committee that I will look very carefully into the matters which have been 697 brought to my attention. I sympathise to some extent with the criticism which has been made about the number of regulations which have been issued, and if anything could be done to codify or simplify them that work would have my heartiest sympathy, but I must remind hon. Members that these regulations are documents which have the force of law, and they have been couched in legal language, and legal language in complicated matters is sometimes not easy to follow. Many of the leaflets, the number of which is complained of, have been rendered necessary in the effort to put into simple and popular language the effect of the regulations, so that we have to get on the one hand the legal document which has the force of law And the simple, popular exposition. With reference to the question of medical research, the sum which is devoted to that purpose was distinctly contemplated under Section 16 of the Act, and, obviously, if by means of medical research connected with the Act you can lessen the amount of sickness prevailing in the country, the expenditure of this money will enormously benefit and relieve insurance funds. That is the justification of this. The hon. Gentleman (Sir J. D. Rees) has commended to my notice the care of the outworkers. I will carefully look into that, and also into the question of stock medicines. I am entirely in sympathy with the general position laid down by the hon. Member. The insured person is wholly entitled to proper and thoroughly efficient treatment.
Then I think the only other points that I need speak about for the moment are the very large questions which were suggested by my hon. Friend (Mr. Booth). I was sorry he thought it necessary to explain that the approved societies, of which he has such intimate knowledge, are not satisfied with the amount of sympathy that they receive from the Insurance Commissioners. I have not myself come across any instance of that. I think we all appreciate their work and appreciate democratic management. We regard them as an integral part of the scheme devised in the Insurance Act, and I can only hope that my hon. Friend for once, in spite of his knowledge, has not rightly interpreted their real feelings, and that the case is not so black as he depicts it. He asked me to embark upon conjectures, prophecies and estimates as to the actual effect of the War upon the position of women and approved societies. With the utmost desire to gratify him, I think, as 698 I am not a prophet, at the present time I had better not embark on these large speculations. As a matter of fact, only yesterday I received a deputation from the British Medical Association which raised some of these points, and the association promised that it would lay before the Commission such evidence as it could collect bearing on this somewhat difficult question. I am afraid for the present I have not sufficient information at my disposal to form any really effective and satisfactory judgment on the point. Therefore on that point I must ask my hon. Friend to wait.
As for the point about valuation, that is a matter which is of importance, and I think I must say a word about it. It would be very disastrous if the valuation were indefinitely postponed. It is necessary in the scheme of the Act that valuation should take place. Under the Act it was to begin on 15th July, or such other date as might be appointed by the Joint Committee. I think it is obviously right—I cannot go further than that at present—that valuation should not begin before 31st December of this year in order that there may be three full years on which to base it. My hon. Friend (Mr. Booth) pointed out, truly, that you might have in an individual year an excessive amount of sickness, and you want three years to get the average. I am fully aware of the large and difficult problem involved, and I wished to hear what the House of Commons had to say on the subject, and I wished also to listen to the views of my hon. Friend. I cannot go further than to say that the valuation will be postponed until 31st December, and meanwhile I shall take an opportunity of making a further announcement on the subject.
§ Mr. BOOTH
I did not mean my inquiry about women and their rate of sickness to be confined to the War. That was a point I raised, certainly, but my main point was the experience up till now, not any conjecture, shows that 7s. 6d. cannot be paid. I do not know whether my hon. Friend is in a position to make a statement.
§ Mr. ROBERTS
I think that is a question connected with the whole problem of valuation. I will only say in answer to the hon. Baronet (Sir F. Banbury) that I still think my figure of £7,000,000 is right for the contributions of the State to Health Insurance. I do not know that he has much encouraged the smoking flax of economy by his strictures; nor can I be wholly satisfied with 699 the attitude of the House of Commons in mons has taken in reference to the faint indications in that direction which I have suggested. My real point was that I could not see anywhere in the administration of the Acts these large sweeping economies of millions which the critics in the Press think they can descry. I think they can only descry them in virtue of the elementary blunders which they themselves have made.
§ Mr. ROBERTS
Of the £3,500,000, £2,500,000 is the expenditure of the approved societies and the insurance committees. My hon. Friend (Mr. Booth) rightly points out that the expenses of the approved societies are not excessive as a general rule. There may be special cases, no doubt, but if any economies are made in that sum by them they go not to the Exchequer but in increased benefits, and if the hon. Member asks me whether that sum is too great, it was calculated in the Act on the analogy of the working expenses which were the fair normal cost of running the large friendly orders. It is rather less than the large friendly orders in the pre-Insurance Act days actually spent, and, therefore, so far as that sum of £3,500,000 is concerned, I am afraid when you look into it all you can see is a possibility of minor economies, the importance of which I do not neglect but which must not be exaggerated.
§ Mr. ROBERTS
In the £3,500,000, as I carefully explained in my opening speech, I have included not merely the money on the Insurance Vote, but also all the other money which is properly to be attributed to the work of National Health Insurance on the Post Office Vote, the Vote of the Stationery Department, and all the other Civil Service Estimates. In reference to other points, I have only to assure the members of the Committee that I will lay their strictures to heart and will do my best to consider their suggestions with a view to improving the administration of the Bill.
§ Colonel YATE
Will the hon. Gentleman answer my question about soldiers transferred from military hospitals?
§ Mr. ROBERTS
So far as I know, the institutions are ready to take every tuberculous soldier discharged from military 700 hospital. I know a very considerable number of them have been so treated without any interval between their discharge from, hospital and their admission into sanatoria. The insurance committees have cooperated very heartily on that point.
§ Sir F. BANBURY
I quite agree with the hon. Gentleman that it would be impossible without repealing the Act to effect certain economies, but I never suggested that. What I suggested was, and I confined myself to the question of administration, whether some economy might be effected, seeing that something: like £1,400,000 has been spent upon administration. I do not quite gather from the reply of the hon. Gentleman whether he was prepared to give me any assurance upon that point, or whether he rather passed it over by dealing with the criticisms in the Press, who apparently are asking for economies of a kind which I myself do not ask for. I was most careful to say that I did not want to bring forward controversial matters at the present time, because you cannot economise in many directions unless you repeal the Act. The hon. Gentleman says the cost will be about £7,000,000, and that therefore my figures are wrong. Supposing his figures are right. That only strengthens my position, because he does not deny that without including the cost of rent, paper, stationery, etc., and such items, the cost of administration is something like £1,400,000. There is also the cost of the Audit Department, which I forgot, and which amounts to £91,000 for salaries and wages, and £15,000 for travelling expenses. That has to be added. If you diminish the sum given without diminishing the expenses of administration you increase the percentage of cost for administration, and therefore that strengthens my point, and shows that the cost of administration really is much in excess of what it ought to be. In reading the Vote I noticed that the old age pensions, which cost the State £13,000,000, only cost £65,000 per year for administration. If that be so, how can the hon. Gentleman reconcile the cost of administration for the Insurance Fund, which he says only costs the State £7,000,000—I say it costs more—while the cost of administration is nearly £1,500,000? I draw the attention of the hon. Gentleman to this in the hope that he will take an example from the cost of the administration of the Old Age Pensions Act with a view to effecting some economy in the 701 direction of the administration of the Insurance Act. May I have some sympathetic assurance from the hon. Gentleman before we pass to the Vote that some effort will be made to effect economy in what are minor matters.
§ Mr. ROBERTS
I can give an assurance to the hon. Baronet that I will look into the matter with an anxious desire to act in the direction that he wishes; but if he asks me for a definite assurance as to any particular figures, I certainly cannot give it.
§ Question put, and agreed to.